Enhancing Post-Mastectomy Care: Telehealth's Impact on Breast Reconstruction Accessibility for Breast Cancer Patients

Abstract

Objective: To examine how the recent sharp rise in telemedicine has impacted trends in accessibility of breast reconstruction (BR).

Patients and methods: A retrospective study reviewed patients who underwent a total mastectomy at our institution from 1 August 2016 to 31 January 2022. By comparing cohorts before and during the widespread implementation of telemedicine, we assessed telehealth's impact on healthcare accessibility, measured by distance from patients' residences to our institution.

Results: A total of 359 patients were included in this study. Of those, 176 received total mastectomy prior to the availability of telemedicine, and 183 in the subsequent period. There were similar baseline characteristics among patients undergoing mastectomy, including distance from place of residence to hospital (p = 0.67). The same proportion elected to receive BR between groups (p = 0.22). Those declining BR traveled similar distances as those electing the procedure, both before the era of widespread telemedicine adoption (40.3 and 35.6 miles, p = 0.56) and during the height of telemedicine use (22.3 and 61.3 miles, p = 0.26). When tracking follow-up care, significantly more patients during the pandemic pursued at least one follow-up visit with their original surgical team, indicative of the increased utilization of telehealth services.

Conclusions: While the rate of BR remained unchanged during the pandemic, our findings reveal significant shifts in healthcare utilization, highly attributed to the surge in telehealth adoption. This suggests a transformative impact on breast cancer care, emphasizing the need for continued exploration of telemedicine's role in enhancing accessibility and patient follow-up in the post-pandemic era.

Keywords: breast cancer care; breast reconstruction; telemedicine.

Figure 1

Map of pre-telemedicine and peak-telemedicine cohort residencies. Figure uses map data from © Mapbox and © OpenStreetMap and their data sources, which are available under the Open Database License. To learn more, visit https://www.mapbox.com/about/maps/ (accessed on 5 July 2024) and http://www.openstreetmap.org/copyright (accessed on 5 July 2024).

Figure 2

Flowchart of breast reconstruction patients’ care at our institution with detailed descriptions of services associated with the specific visit. Blue boxes represent appointments that can be converted to a telehealth format.